Flexible endoscopes became generally available 50 years ago and created a revolution in the practice of gastroenterology. They enormously improved diagnosis, enabled quicker, less invasive, and more cost-effective surgical treatment, whilst endoscopic screening has prevented many cancer deaths. The new technology stimulated research leading to a better understanding of gastrointestinal pathology, identifying new diseases and clarifying the etiology of others. Better-controlled clinical trials accelerated the use of newer and more effective drugs. National and international endoscopy societies supported nursing input, encouraged research, stimulated specialist journals, and devised guidelines that encouraged audit and quality assurance. Advances in instrument design and the manufacture of new accessories enhanced endoscopic technique, diagnostic ability, patient comfort, and safety. The risk of cross-infection inherent in the use of complex labile equipment that cannot be autoclaved remains a challenge. Endoscopy societies working closely with industry have established rigid protocols for high level disinfection that minimize the risks, but strict adherence to guidelines and continued vigilance is essential especially with the increasing prevalence of antibiotic-resistant commensals that can give rise to opportunistic infection. Government health departments have a responsibility to encourage and support research in this area by endoscopists, instrument manufacturers, and the pharmaceutical industry. Current trends suggest that in the future, artificial intelligence will greatly improve endoscopic diagnosis, and that therapeutic endoscopy will expand, encouraging endoscopists to subspecialize.

中文翻译：

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消化内镜 50 年：成功、挫折、解决方案和未来

柔性内窥镜在 50 年前普遍可用，并在胃肠病学实践中掀起了一场革命。它们极大地改善了诊断，实现了更快、侵入性更小且更具成本效益的外科治疗，同时内窥镜筛查已防止许多癌症死亡。新技术刺激了研究，从而更好地了解胃肠道病理学，识别新疾病并阐明其他疾病的病因。更好控制的临床试验加速了更新和更有效药物的使用。国家和国际内窥镜学会支持护理投入，鼓励研究，刺激专业期刊，并制定鼓励审计和质量保证的指南。器械设计和新配件制造的进步增强了内窥镜技术，诊断能力、患者舒适度和安全性。使用不能高压灭菌的复杂不稳定设备固有的交叉感染风险仍然是一个挑战。与行业密切合作的内窥镜协会已经制定了严格的高水平消毒方案，以最大限度地降低风险，但严格遵守指导方针和持续警惕是必不可少的，尤其是随着可引起机会性感染的抗生素抗性共生体的日益流行。政府卫生部门有责任鼓励和支持内窥镜医师、仪器制造商和制药行业在该领域的研究。目前的趋势表明，未来人工智能将极大地改善内镜诊断，治疗性内镜将扩大，